title: How to decrease suicide rates in both genders? An effectiveness study of a community-based intervention (EAAD).
abstract: BACKGROUND
  The suicide rate in Hungary is high in international comparison. The two-year community-based four-level intervention programme of the European Alliance Against Depression (EAAD) is designed to improve the care of depression and to prevent suicidal behaviour. Our aim was to evaluate the effectiveness of a regional community-based four-level suicide prevention programme on suicide rates.
  
  
  METHODS
  The EAAD programme was implemented in Szolnok (population 76,311), a town in a region of Hungary with an exceptionally high suicide rate. Effectiveness was assessed by comparing changes in suicide rates in the intervention region after the intervention started with changes in national suicide rates and those in a control region (Szeged) in the corresponding period.
  
  
  RESULTS
  For the duration of the programme and the follow-up year, suicide rates in Szolnok were significantly lower than the average of the previous three years (p = .0076). The suicide rate thus went down from 30.1 per 100,000 in 2004 to 13.2 in 2005 (-56.1 %), 14.6 in 2006 (-51.4 %) and 12.0 in 2007 (-60.1 %). This decrease of annual suicide rates in Szolnok after the onset of the intervention was significantly stronger than that observed in the whole country (p = .017) and in the control region (p = .0015). Men had the same decrease in suicide rates as women. As secondary outcome, an increase of emergency calls to the hotline service (200%) and outpatient visits at the local psychiatry clinic (76%) was found.
  
  
  CONCLUSIONS
  These results seem to provide further support for the effectiveness of the EAAD concept. Whilst the majority of suicide prevention programs mainly affect female suicidal behaviour, this programme seems to be beneficial for both sexes. The sustainability and the role of the mediating factors (social service and health care utilization, community attitudes about suicide) should be key points in future research.
authors.affiliation: Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary.
authors.forename: András
authors.initials: A
authors.lastname: Székely
authors.forename: Barna
authors.initials: B
authors.lastname: Konkolÿ Thege
authors.forename: Roland
authors.initials: R
authors.lastname: Mergl
authors.forename: Emma
authors.initials: E
authors.lastname: Birkás
authors.forename: Sándor
authors.initials: S
authors.lastname: Rózsa
authors.forename: György
authors.initials: G
authors.lastname: Purebl
authors.forename: Ulrich
authors.initials: U
authors.lastname: Hegerl
mesh_terms: D019058:Community Networks / Q000706:statistics & numerical data*; D003863:Depression / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D016014:Linear Models; D008297:Male; D015397:Program Evaluation / Q000706:statistics & numerical data*; D013405:Suicide / Q000706:statistics & numerical data*; D000092864:Suicide Prevention